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European Journal of Heart Failure 2009 11(10):922-928; doi:10.1093/eurjhf/hfp126
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

Intake of very long chain n-3 fatty acids from fish and the incidence of heart failure: the Rotterdam Study

S. Coosje Dijkstra1,2, Ingeborg A. Brouwer1,3, Frank J.A. van Rooij2, Albert Hofman2, Jacqueline C.M. Witteman2 and Johanna M. Geleijnse1,*

1 Division of Human Nutrition, Wageningen University, PO Box 8129, 6700 EV Wageningen, The Netherlands
2 Department of Epidemiology and Biostatistics, Erasmus MC, PO Box 1738, 30000 DR Rotterdam, The Netherlands
3 Institute of Health Sciences, VU University Amsterdam, De Boelenlaan 1085, 1081 HV Amsterdam, The Netherlands

* Corresponding author. Tel: +31 317 482 574, Fax: +31 317 483 342, Email: marianne.geleijnse{at}wur.nl


  Abstract

Aims: Evidence is accumulating for a cardioprotective effect of fish or its n-3 fatty acids, eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA). We examined EPA plus DHA and fish intake in relation to incident heart failure in the population-based Rotterdam Study.

Methods and results: The analysis comprised 5299 subjects (41% men, age ~68 years) free from heart failure for whom dietary data were available. During 11.4 years of follow-up, 669 subjects developed heart failure. The relative risk (RR) of heart failure in the top vs. bottom quintile of EPA plus DHA intake was 0.89 (95% CI 0.69–1.14), after adjustment for lifestyle and dietary factors. For fish intakes ≥20 g/day, the RR was 0.96 (0.78–1.18) compared with no fish intake. In sex-specific analysis, a high EPA plus DHA intake tended to be protective in women (RR = 0.75, 0.54–1.04) but not in men (RR = 1.00, 0.73–1.36). An inverse association for EPA plus DHA was also observed in diabetics (RR = 0.58, 0.32–1.06), which was borderline statistically significant.

Conclusion: Our findings do not support a major role for fish intake in the prevention of heart failure. The potentially protective effect of EPA plus DHA in diabetic patients, however, warrants further investigation.

Key Words: Heart failure • Fish • N-3 fatty acids • Population-based study • Prevention

Received May 27, 2009; Revised July 24, 2009; Accepted August 7, 2009


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